The White House Office for Health Reform held the fourth of five Regional Health Forums in my hometown of Greensboro, NC, on Tuesday morning, so I decided to stop by. The event lasted less than two hours, not nearly enough time to hear from the approximately 400 people in attendance or engage in deep discussion. North Carolina Governor Beverly Perdue and Nancy Ann DeParle, director of the White House Office for Health Reform, presided over an event that was mostly orchestrated: many of the audience questions and comments came from individuals who had been pre-selected to speak. Individuals with special medical needs shared their struggles with the health care system; small business owners told of high health insurance costs forcing difficult decisions; and health practitioners (about half the audience were clinicians, by show of hands) imparted tales of conflict between their medical judgment and the strictures imposed by insurance companies.
The forum was heavy on tales of woe and scary statistics, but disappointingly light on concrete policy remedies. Among the few changes proposed were Governor Perdue's promotion of North Carolina Community Care as a successful model for similar national programs and an orthopedic surgeon's suggestion that tax breaks be given to physicians who treat uninsured individuals. DeParle acknowledged these concerns and said she would pass them on to the president, adding "There's money that needs to be moved around." She offered no new proposals of her own, instead reiterating that health reform is near the top of Obama's agenda and that he wants to see major legislation by year's end.
The dialogue echoed the administration's hallmark "post-partisan" centrism, with many stressing solutions that all sides can support. While no speaker made an explicit call for single-payer health coverage, an MD received a roar of applause by saying that Obama must exhibit persistence in advocating for the creation of a well-run, evidence-based public insurance option. To my chagrin, no speaker framed the issue in terms of health care being a human right, a rhetorical shift that would alter the terms of the debate. After all, it is nearly impossible for the infirm, without medical help, to enjoy or exercise any other right or to engage in the pursuit of happiness.
Nevertheless, one local pediatrician (and unsuccessful 2008 Congressional candidate), Teresa Bratton, is made optimistic by the White House's attempts at outreach. But she worries that the longer it takes to put together a comprehensive reform plan, the less time advocates will have to build political support for it. The forum's mood suggests that the moment is ripe for major changes to gain traction, given that only insurance companies are defending the status quo. Now all we need are some concrete plans to get behind.
-- Malcolm Kenton
